摘要
Objectives:The study aimed to the multicenter application of a nursing workload measurement scale in the internal medicine and surgery adults hospitalization units.Methods:The study design was a multicenter,observational,and descriptive study.A multicenter application of the MIDENF®nursing workload measurement scale was carried out,which consists of 21 items,and covers the four nursing functions(patient care items,teaching,manager,and researcher),in units of hospitalization of adults of internal medicine and surgery of four different hospitals.Each item contains one or more of the nursing interventions of Nursing Interventions Classification(NIC)and has an assigned time,after comparing the real time it takes to perform each intervention with the North American Nursing Diagnosis Association(NANDA)standardized time.The study was carried out during nine months of the year 2020,measuring two days each month in the three work shifts(morning,evening,and night)to all patients admitted on the days of measurement in the indicated units.Results:The descriptive and inferential analysis of 11,756 completed scales,5,695 in general surgery and 6,061 in internal medicine,showed a greater care load for the two units during the morning shift(227,034 min in general surgery,261,835 min in internal medicine),especially in the items of“self-care”,“medication”,“common invasive procedures”,“fluid therapy”,and“patient and family support”,while the managerial function was similar during the three work shifts in the two units studied,getting values between 57,348 and 62,901min.In the analysis by shift and unit,statistical significance was obtained both for the total workload and the four nursing functions(P<0.001).Conclusions:It is shown that the use of validated scales with the standardized language of nursing functions,adapted to the units,provides objective information to adjust the nursing staff to the real situation of care in any hospital and unit where it is applied,improving quality and patient safety.
目的旨在应用护理工作量测量统计表对不同医院内外科成人住院病房的护理工作量进行估算。方法采用多中心、观察性、描述性研究方法。应用护理工作量测量统计表对4所医院内外科住院病房进行调查,该统计表中将护理工作按功能分为4种(患者护理、教学、管理和研究),共21个项目。每个项目都包含1个或多个护理干预分类(Nursing Interventions Classification,NIC)中的护理干预措施,并在将执行每项干预措施所需的实际时间与北美护理诊断协会(the North American Nursing Diagnosis Association,NANDA)的标准化时间进行比较后,为每一项干预措施确定具体时间。在2020年的9个月期间,每个月测量两天,对指定病房当天护理人员3个班次(早班、下午班及晚班)护理工作量进行统计(涉及当天入院所有患者)。结果共完成11756份统计表单(外科5695份,内科6061份)。早班护理工作量较大(外科总计227034 min,内科总计261835 min),特别是自我护理、药物治疗、常见侵入性操作、液体治疗和患者与家庭支持项目;不同病房不同班次管理方面的工作量则较为相近,各班次合计在57348到62901 min之间。对不同班次及不同医院护理工作量进行比较,总工作量和4类护理功能工作量的差异均具有统计学意义(P<0.001)。结论采用经过验证的、基于标准化护理功能术语、适用于病房的统计表单,可提供关于护理工作量的客观数据,用于调整护理人力安排,以适应不同医院和科室的实际情况,从而提高护理质量和患者安全。
